After physician-assisted suicide laws failed to gain traction in the 1990s, states across the country again are proposing — and passing — legislation on the matter, all in the name of a patient’s right to choose.

Sound familiar?

Kathleen M. Gallagher, director of pro-life activities at the New York Catholic Conference, likened the growing push in the United States to legalize physician-assisted suicide to the evolution of abortion laws. If it’s acceptable for members of society to make choices at the beginning of life, why not at the end of life, too?

Gallagher

“[There’s a] whole notion of individual choice that’s become so prevalent in our society, almost cemented in our society,” Gallagher said. “Instead of a nation of solidarity, of family and community, it’s become a nation of narcissists.”

Abortion became legal in 1973, and today, many Christian and Catholic employers alike are faced with enormous fines if their employee health plans don’t include access to abortifacients. Because of their lawsuit against the contraception mandate, the Little Sisters of the Poor, whose mission is the care for the elderly and the dying, were added in July to the National Organization for Women’s “Dirty 100” list of businesses to boycott.

A movement that started 41 years ago with legally allowing women to terminate unborn children has spiraled downward from a choice to a “right.” Where will all this choice regarding human lives end? It looks as if the next battle is here.

Death with dignity?

The pro-assisted suicide organization Compassion & Choices (originally the Hemlock Society until 2003, but now strategically rebranded and renamed) has been determinedly canvassing to change state laws. Their website hosts a tri-colored map designating the states that have “death with dignity,” those that are “campaign states” the group is targeting and the states that have assisted suicide laws “in progress.”

The Little Sisters’ hospitality vow manifests the power of love expressed in quiet, daily service to sick and infirm elderly. Courtesy photo

Compassion & Choices claims to be the “leading nonprofit organization committed to helping everyone have the best death possible.” According to the site, the organization’s goal is to “make aid in dying an open, legitimate option recognized throughout the medical field and permitted in more states,” in addition to “normalize accurate, unbiased language throughout the end-of-life choice discussion.” They also “support the expansion of the end-of-life choice movement and exert a leadership role in it.”

Dying with dignity and allowing oneself to die aren’t opposed to Church teaching, as modern culture might claim.

“They think that the Church teaching is black and white,” said Gallagher. “It’s really not. It says that every single case needs to be looked at as a single case.”

So why the concern over this movement when “death with dignity” sounds like a good thing? The euphemisms and language used by Compassion & Choices are meant to sound innocent, said Patrick Brannigan, executive director of the New Jersey Catholic Conference.

“What they do is basically mislead everyone by saying ... physician-assisted suicide is really the same as hospice and palliative care, which it is not,” Brannigan explained.

It’s difficult for the average person who isn’t in the medical profession or some type of social work or hospice care to “make the distinction between alleviating the pain of someone and killing them,” Brannigan added.

A doctor’s take

“Often, when we’re talking about ending suffering, particularly in people who are nearing the end of life, we’re not talking about people dying in pain. In almost every case, pain can be controlled,” said Dr. G. Kevin Donovan, the director of the Center for Clinical Bioethics at Georgetown University in Washington, D.C.

Although not true in every case, the decision to end a life isn’t always made solely with the patient’s well-being in mind.

Donovan

Brannigan

“What we’re really talking about is something different than pain when we say ‘suffering.’ We’re talking about emotional, spiritual suffering,” Donovan explained. “Quite often that suffering is not confined to the patient alone. It’s the families that say, ‘I just can’t take this.’ It’s the doctors and nurses who say, ‘This is just so sad, this is going on too long.’”

Perhaps even more sinister is Donovan’s point that death is more cost-effective.

For example, an insurance company in Oregon told a cancer patient that they couldn’t pay for another round of expensive chemo, but they would pay for an assisted suicide.

“How are patients going to trust their physicians to act with their best interests at heart and try to be healing them?” Donovan asked. “Patients should also be extremely afraid of a system that thinks that good care includes killing them.”

And although euthanasia is not legal in the United States, as it is in Belgium and the Netherlands, “what makes us stop at physician-assisted suicide?” Donovan said.

Donovan said it’s a slippery slope. Belgium and the Netherlands had a certain set of criteria, which Donovan said has gone to the wayside and is openly criticized.

“Physicians have written learned articles in medical journals saying that they think it’s their responsibility to both end suffering and potential suffering, whether it’s requested or not,” Donovan said. “This sounds unimaginable, but in fact it’s not only imaginable but predictable and logical.”

How could killing someone without their consent possibly be predictable and logical?

“Once you’ve defined something as being acceptable, it’s a very short throw to say it is acceptable because it is good,” Donovan said. “And if it is good, then why are we placing restrictions on people and denying them access to that good?”

Father Kenneth Letoile administers the sacrament of Anointing of the Sick at Jeanne Jugan Residence, Washington, D.C. Courtesy photo

For example: Someone is comatose and can’t ask for physician-assisted suicide. They are not terminally ill, but they are suffering. Why should relief be denied if killing a patient in pain has been deemed a compassionate thing to do?

“Once you have defined that killing people for their own good is a good thing to do ... then restricting it in almost any fashion seems untenable,” Donovan said.

In the Netherlands, there are no restrictions on circumstances. They range from depression, aging, anorexia, abuse and deafness to euthanizing infants who may have disabilities that might affect their lives (with an emphasis on the “might”). Children 12 years and older are allowed to kill themselves.

Not only do these examples raise red flags for the human lives at stake but also for the medical profession in general.

“To put this in the lap of medicine and make this a professional obligation is one way of severely damaging — if not destroying — the profession,” Donovan said.

Brannigan cited statistics that in 2012 more active duty military members committed suicide than were killed in combat.

“The issue is depression,” he said. “When people are depressed, they deserve our loving care — treatment — and usually once they get that, they stop thinking about suicide. It’s our duty to help people, not to kill them.”

Changing minds

In New York, a strong law on the books prohibiting physician-assisted suicide was upheld as constitutional by the U.S. Supreme Court in 1997 when the law was challenged. That law remains intact. But in 2012, a House bill was introduced that would have repealed the ban.

Visiting the sick is a corporal work of mercy, by which we extend the compassion of Christ to those in need. Shutterstock

Gallagher approached the sponsor and asked why he introduced the bill. The reason wasn’t because a loved one or a family member had faced a terminal illness. He told her that one of his staff members read about a law in Oregon and, according to Gallagher, he said “it sounded very compassionate. So I looked it up and put in a bill to do what they did.”

Gallagher was stunned, and through productive meetings, she was able to convince the legislator to withdraw the bill in May 2012.

If you believe that physician-assisted suicide is so good and that this should be part of a physician’s healing ministry, she asked him, why limit it to doctors? Why not include other emergency personnel like police officers? That argument proved to be his “ah-ha” moment. Gallagher said statistics from Oregon helped sway the lawmaker. In its publication “Physician Assisted Suicide: Know the Facts,” the Maryland Catholic Conference cited a study from the Centers for Disease Control and Prevention, which showed that the suicide rate in Oregon (where physician-assisted suicide is legal) increased 49.3 percent from 1999-2010, compared to 28 percent nationally. A 2012 study by the Oregon Health Authority revealed that the suicide rate in the state of Oregon is 41 percent higher than in the rest of the nation.

Legislation

In New Jersey, Gov. Chris Christie has committed to vetoing an assisted-suicide bill if it gets to his desk. There’s little chance a bill would become law, but Christie is in his final term, and after he leaves office, it’s anyone’s guess as to what could happen.

“The true answer cannot be putting someone to death, however 'kindly,' but to bear witness to the love that helps us to face pain and agony in a human way. We are certain: No tear, whether it be of those who suffer or those who stand by them, goes unnoticed before God.” — Pope Emeritus Benedict XVI

“What Compassion & Choices is doing is not a one-time, one-year [campaign],” Brannigan said. “This is a multi-year effort [where] they hope to [check] off one or two legislators now, one or two in the future.”

In the proposed New Jersey law, Brannigan said, the bill would allow the medical doctor to indicate the cause of death as the underlying disease, not suicide. This is how the law currently operates in Oregon. “That borders on a fraudulent statement on a legal document,” Brannigan said.

New York faces a greater challenge than just the state pushing through an outright suicide bill, Gallagher said, as the legislature is attempting to weaken the state’s current laws on advanced directives and advanced care planning that would lower the standards for people unable to make their own health care decisions.

In 1990, New York enacted a health care proxy law that allows a person to name somebody else to be his or her health care decision-maker should the patient become incapacitated. In the following 20 years, fewer than 50 percent of New Yorkers had named an agent under the health care proxy law.

“Our bishops are supportive of health care proxy law,” Gallagher said. “It can be a morally appropriate tool for making your wishes known.”

But in 2010, the legislature passed a surrogate decision-making law. If a hospitalized patient has not assigned a health care proxy, the hospital will appoint one from a priority list (husband, sibling, child, parent, etc.). The New York Catholic Conference was able to heavily amend two laws so there were more safeguards for vulnerable populations.

Among other successes, Gallagher said they were able to beat back attempts to remove the need for a second witness as well as the requirement for a physician to be present.

In 2011, the N.Y. Catholic Bishops published “A Catholic Guide to End of Life Decision Making,” to help guide the faithful. In it they wrote, “When choosing someone to be your health care agent, it is important to choose someone known to be of good moral character, who knows you well, is familiar with your religious beliefs, has the ability to understand medical information, operates well under stressful conditions, and who will be sure that end-of-life decisions on your behalf are made in accord with the Church’s moral teachings.”

Education needed

What’s the solution to all this? Donovan said we need a “massive re-education” and to lobby our state and federal legislators on the issue through the U.S. Conference of Catholic Bishops, state conferences and other trustworthy organizations. People also need to educate themselves on Church teaching regarding end-of-life issues.

“The Church’s teaching is so rich and so beautiful and our support for palliative care and hospice and pain management,” Gallagher said. “People just don’t know about that.”

Physician-assisted suicide laws are “sweeping people under the rug,” Donovan said. “And over the cliff.”

Mariann Hughes writes from Maryland.

Six Commonly Asked Questions

What is physician-assisted suicide?

Physician-assisted suicide occurs when a physician provides a patient a prescription for a lethal overdose of a drug, to be ingested by the patient for the purpose of ending his or her life. Assisted suicide differs from euthanasia, which occurs when a doctor or another person administers a drug to (or withholds treatment from) a patient with the direct intent of causing the patient’s death. In both cases, however, another party is intentionally complicit in the patient’s death.

Which states currently allow physician-assisted suicide?

Oregon was the first state to legalize assisted suicide, by a statewide vote in 1994. Washington State followed suit in 2008. Montana’s Supreme Court ruled in 2009 that a physician may not be criminally liable under current state laws for assisting in a terminally ill patient’s suicide, although there is no actual state law allowing the practice. Vermont’s state legislature passed a measure legalizing assisted suicide in May 2013. A New Mexico court decided in January 2014 that it’s a fundamental right for “a competent, terminally ill patient to choose aid in dying.”

Why does the Catholic Church oppose it?

The Catholic Church teaches that physician-assisted suicide gravely violates the sacred value of all human life, particularly of those who are vulnerable due to illness, age or disability, and undermines the medical profession’s healing mission.

What does the Church teach about caring for patients at the end of life?

The Church does not teach that life must be prolonged by every possible means. The Church does teach that we should take reasonable steps to sustain our lives, including the use of beneficial medical treatments and of effective means for conveying nourishment and fluids.

What other groups oppose assisted suicide?

The American Medical Association, the American College of Physicians, the American Nurses Association, the National Hospice & Palliative Care Organization, the National Council on Disability and numerous other medical, palliative care and disability organizations oppose physician-assisted suicide.

What has the U.S. Supreme Court said about assisted suicide?

In 1997, the court rejected the claim of a constitutional “right” to assisted suicide and upheld state laws against assisted suicide in New York and Washington State as constitutionally valid and serving legitimate purposes.